On Nipple Shields and BreastfeedingPosted: November 7, 2015
Note: This post will talk about breastfeeding in some detail. I don’t believe it will be a crass discussion, but my idea of modesty was completely skewed after pushing a baby out of my body. If discussing breastfeeding makes you uncomfortable, I instead offer this old post that has nothing to do with parenting and everything to do with the time we almost burned down the farm.
If you are to say, “Nipple shield” in front of a mother who has breastfed, you’ll get various reactions. Some will laud this tool as a miracle that saved their breastfeeding relationship. Others will declare that using one just lead to more problems. Some of the more hardcore lactavists will sneer at it as an unnecessary device that just encourages a newborn to be lazy and not fix a bad latch. And some mothers will say, “Nipple shield? What’s that?”
I fancy myself as a bit of an expert on using a nipple shield since I’ve been nursing Babykins with one for over 13 months. Do I recommend using one for that long? No, but it is what it is at this point.
A nipple shield is a thin piece of silicon that is often described as having the shape of a tiny sombrero. The shield is placed over a mother’s nipple during a feeding session. It is supposed to help breastfeeding is several ways. First, it’s supposed to protect the mother’s nipple from her baby’s strong suck, especially during the early days when both mother and baby are trying to figure out how to get a good latch, especially if the mother has flat or inverted nipples. It’s also useful for controlling milk flow when a mother has an overactive letdown or if a baby has a small mouth (this is especially useful for premature babies). I was given one by my hospital’s Lactation Consultant (LC) because Babykins managed to maul my breast in less than 24 hours after her birth (I think we got an “A” for effort and “F-” for execution).
A tool that helps with nursing pain? Why don’t all mothers use one?!
As mentioned, the nipple shield can salvage a faltering breastfeeding relationship. It can also complicate it. There are 3 primary concerns when using a nipple shield.
- It enables a mother and baby to keep using a bad latch. While this can sometimes be true, most mothers want to wean off the shield as quickly as possible, so they continue to try to fix their baby’s latch. The shield can make it more bearable as they do this.
- It can cause a mother’s milk supply to drop. Because the shield does create a barrier between the mother’s skin and her baby’s mouth, this can mean that the baby won’t empty the breast properly. This in turn can signal the mother’s body to make less milk.
- It can lead to poor weight gain for the baby. Sometimes the shield can prevent the baby from getting as much milk as they would without the shield. Likewise, if the mother isn’t producing enough milk, this can affect a baby’s weight gain. This is the main problem Babykins and I had while using the shield. She’s always gained slowly and we still don’t know if the shield was the cause of this or if it’s just her genetics. However, since she never took to a bottle (she spit everything back up, even after buying a fancy-pants bottle nipple) and refused to nurse without a shield, we just kept plugging along.
Other problems include increase risk of infection, a baby refusing to latch with the shield, and problems weaning off the shield.
But I’m using a shield! What should I do?
I have 3 main pieces of advice for mothers using a breast shield.
- Nipple shields should be used under the guidance of an LC. Many women don’t realize this, especially since shields can be easily purchased at places like Target or Amazon. An LC will help a mother and baby get a good latch and will be able to watch for breastfeeding problems. I’ll recommend trying a nipple shield for any mother having nursing problems, but I always tell them to do so with the help of an LC.
- A baby nursing with a shield should be weighed at least every 2 weeks. This helps to catch any weight gain problems early. Also count their wet and dirty diapers like you would for any baby.
- A mother nursing with a shield should pump or hand express at least once a day (or more if the baby is having problems emptying the breast). This will help the mother’s milk supply and help prevent mastitis.
Weaning off the shield
Admittedly, I’m probably not the best person to give advice about shield weaning since we’re still using one, but here are some of the more common techniques I was told.
- Start the nursing session with the shield and pull it off after your milk letdown (you know, so you don’t drown your baby with your milk geysers).
- Offer you shield-free nipple when baby is sleepy.
- Go cold turkey. Take the shield away for a couple of days to see if your baby will figure it out.
Keep in mind (especially with #3) that you don’t want to make weaning into a battle. This can lead to a nursing strike. If things start getting ugly and your baby is becoming upset, use the shield and comfort that baby!
Tips for the long haul of shield use
My lactation consultant told me that average use of a nipple shield is about 21 days. Some babies take longer to wean. Some babies never wean (*cough* Babykins *cough*). Here are some useful tips I’ve found for long-term nipple shield use:
- Keep more than one shield on hand. This is especially useful if you have more than one nursing station in your home. It’s such a pain to get set up for a nursing session with your floppy newborn, only to realize that your shield is at the opposite end of the house. It’s also useful for those times that your flailing baby knocks the shield off in the middle of the night and you can’t find it in the dark.
- Always keep a spare shield in your diaper bag. It’s a terrible moment when your baby is screaming to be fed or comforted when you are out and about and you realize you left the shield at home. I learned that at Babykins’s 2-week doctor’s appointment. o.O
- Wash the shield with mild soap and water. This will keep it clean and prevent infection. If it starts looking scuzzy, replace it.
- To help the shield suction to your skin, lick your finger and rub it on the outer rim of the shield. Seriously, it helps.
Want more information?
For more information, check out KellyMom and The Leaky Boob. Also, I am not a lactation consultant, nurse, or a doctor, just a mom nursing her child. You should find professional help if you are concerned about your baby’s health.
While ideally a mother will be able to nurse without the shield, it is better to have the baby nursing at the breast with the shield than not nursing at all. If you aren’t able to wean off the shield and you have a healthy baby, well, you just keep on nursing your babe the best you can. And if you want to share shield stories, drop me a message because I have many! 🙂